CCO Provider Data Management Analyst

Minneapolis, Minnesota
Nov 09, 2021
Feb 09, 2022
Employment Status
Full Time
Health Care that Starts with You!

Join a truly mission-driven organization! Independent, nonprofit UCare is recognized as one of the Minnesota's leading health plans. We provide more than 225,000 members across Minnesota and western Wisconsin with the health coverage plans and services they need to maintain and improve their health. The innovative coverage we create makes a difference for Medicare-eligible individuals, individuals and families enrolled in Minnesota Health Care Programs, such as MinnesotaCare and Medical Assistance, and disabled adults with special health care needs.

UCare is growing in size, membership, products, geographic coverage, and employees. We're an organization that's going places. Be part of a team that cares about you, be part of UCare.


Enter a highly collaborative environment where people are truly engaged, and feedback is valued. You'll enjoy a competitive salary and benefits, as well as a host of other perks, including a nationally recognized wellness program, and a bright, open, award-winning office space in Northeast Minneapolis just minutes from major freeways and retail centers.

At UCare, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.




UCare offers Medicare, Medicaid, Individual and Family health plans - powered by the hardest working people in the industry. Our people powered teams de-complicate, advocate and always go the extra mile to help our members. We serve with integrity, compassion and commitment to do right by members, providers and government partners. Above all, we come to work excited to provide members a path for the best health of their lives.


Working at UCare is more than a career; it's a mission. A mission that defines us as professionals, unites us as an organization and shapes how we interact with our members and each other. Employees join UCare and stay because of the opportunity to have a purpose-driven job.

Our strong culture has established UCare as a Star Tribune Top 150 Workplace for 12 consecutive years since the awards program began. It's a culture that embraces innovative ideas, strategic partnerships, and exemplary customer and provider experiences. Working at UCare is being a part of a people powered team dedicated to making a real difference in the lives of our members and communities.


Work Location: Work from home, in the office or hybrid (in the office 3 or more days per week)

The health and safety of our employees, members, providers, and our community is our highest priority. Therefore, all new employees are expected to be fully vaccinated against COVID-19 prior to starting at UCare, subject to limited exceptions such as for a sincerely held religious belief or for medical reasons.

Position Description

This position is responsible to enter, update and maintain provider data in HealthRules to ensure alignment with configuration principles and support proper payment of claims for in network and out of network providers. Utilize measures put in place to ensure providers follow CMS and DHS guidelines, and are not held in sanctions prior to setup in core systems. Respond to internal customer requests, questions, and make system updates as needed.

• Add, maintain and terminate providers (suppliers) and provider locations in HealthRules, including demographic changes, Tax ID changes, bank account and trading partner changes and NPI changes. Conduct research as needed to ensure accurate and timely setup.

• Collaborate with configuration analysts to ensure supplier data aligns with configuration principles and supports the efficient and accurate configuration of supplier contracts.

• Ensure compliance with all provider data requirements including screening, certifications, etc. Use MN-ITS, Streamline Verify and the National Plan & Provider Enumeration systems to ensure entities and practitioners are approved through DHS, CMS and not on any sanctions prior to setup.

• Process provider online forms.

• Achieve and consistently maintain quality and production standards.

• Send and reply to communications regarding provider setup to external and internal customers timely and accurately.

• Ensure department service level agreements (SLAs) are met.

• Use critical thinking to determine and resolve issues with incorrect suppliers, practitioner, and supplier locations information.

• Participate in internal discussions, research and recommend processes to improve efficiency.

• Other projects and duties as assigned.


Bachelor's degree in technical or business preferred; demonstrated work experience may be considered in lieu of degree.

Required Experience

Data entry experience. Experience with HealthRules payer application. Microsoft Office experience. Experience in healthcare operations.

Preferred Experience

HealthRules supplier data management and configuration experience.


The UCare difference is our people power - employees actively working on the behalf of our members to get them access to the health care they need. We value and respect each individual's ideas and contributions, and provide the freedom to grow both personally and professionally. We are centrally located, and offer onsite education, equipment and wellness resources, and a myriad of volunteer activities. If you're looking for an inclusive environment that celebrates your people power, helps you build on your strengths and gives you the opportunity to truly make a difference, we invite you to apply.

As an Equal Opportunity/Affirmative Action Employer, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.

JOB POST DATE: 11/08/2021

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